Da Young Lee1, Eun-Jung Rhee2, Yoosoo Chang3, Chong Il Sohn4, Ho-Cheol Shin5, Seungho Ryu6, Won-Young Lee7. 1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea. 2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea. 3. Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea. 4. Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea. 5. Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea. 6. Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea. Electronic address: sh703.yoo@samsung.com. 7. Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: wonyoung2.lee@samsung.com.
Abstract
BACKGROUND: Insulin resistance and inflammation play an important role in a variety of chronic diseases. OBJECTIVE: We investigated the influence of systemic inflammation on the relationship between insulin resistance and mortality risk in apparently healthy adults. METHODS: This study examined the mortality outcomes for 165,849 Koreans enrolled in a health-screening program. The subjects were divided into four groups according to their homeostatic model assessment of insulin resistance (HOMA-IR) and high-sensitivity C-reactive protein (hs-CRP) levels: group 0, HOMA-IR <75% and hs-CRP <2.0mg/L; group 1, HOMA-IR ≥75% and hs-CRP <2.0mg/L; group 2, HOMA-IR <75% and hs-CRP ≥2.0mg/L; and group 3, HOMA-IR ≥75% and hs-CRP ≥2.0mg/L. The Cox proportional hazard models were used to assess hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cardiovascular disease, and cancer-related mortality. RESULTS: During the follow-up period of 1,417,325.6person-years, a total of 1316 deaths (182 from cardiovascular disease) occurred. The multivariate-adjusted HRs for all-cause mortality were significantly higher in groups 2 (HR 1.40; 95% CI: 1.19-1.64) and group 3 (HR 1.68; 95% CI: 1.34-2.10) than that in group 0. For cardiovascular mortality, the sex-adjusted hazards were also significantly higher in groups 2 and 3 than that in group 0; however, this increased risk disappeared during multivariate analysis. Groups 2 and 3 had significantly higher risk for cancer-related mortality than group 0, with multivariate-adjusted hazard ratios of 1.48 (95% CI: 1.18-1.86) and 1.84 (95% CI: 1.35-2.51), respectively. CONCLUSIONS: Systemic inflammation can be used to stratify the subjects according to the all-cause and cancer-related mortality risks, irrespective of the insulin-resistance status. And this tendency is most pronounced in cancer-related mortality.
BACKGROUND:Insulin resistance and inflammation play an important role in a variety of chronic diseases. OBJECTIVE: We investigated the influence of systemic inflammation on the relationship between insulin resistance and mortality risk in apparently healthy adults. METHODS: This study examined the mortality outcomes for 165,849 Koreans enrolled in a health-screening program. The subjects were divided into four groups according to their homeostatic model assessment of insulin resistance (HOMA-IR) and high-sensitivity C-reactive protein (hs-CRP) levels: group 0, HOMA-IR <75% and hs-CRP <2.0mg/L; group 1, HOMA-IR ≥75% and hs-CRP <2.0mg/L; group 2, HOMA-IR <75% and hs-CRP ≥2.0mg/L; and group 3, HOMA-IR ≥75% and hs-CRP ≥2.0mg/L. The Cox proportional hazard models were used to assess hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cardiovascular disease, and cancer-related mortality. RESULTS: During the follow-up period of 1,417,325.6person-years, a total of 1316 deaths (182 from cardiovascular disease) occurred. The multivariate-adjusted HRs for all-cause mortality were significantly higher in groups 2 (HR 1.40; 95% CI: 1.19-1.64) and group 3 (HR 1.68; 95% CI: 1.34-2.10) than that in group 0. For cardiovascular mortality, the sex-adjusted hazards were also significantly higher in groups 2 and 3 than that in group 0; however, this increased risk disappeared during multivariate analysis. Groups 2 and 3 had significantly higher risk for cancer-related mortality than group 0, with multivariate-adjusted hazard ratios of 1.48 (95% CI: 1.18-1.86) and 1.84 (95% CI: 1.35-2.51), respectively. CONCLUSIONS: Systemic inflammation can be used to stratify the subjects according to the all-cause and cancer-related mortality risks, irrespective of the insulin-resistance status. And this tendency is most pronounced in cancer-related mortality.
Authors: Kathy Pan; Rebecca A Nelson; Jean Wactawski-Wende; Delphine J Lee; JoAnn E Manson; Aaron K Aragaki; Joanne E Mortimer; Lawrence S Phillips; Thomas Rohan; Gloria Y F Ho; Nazmus Saquib; Aladdin H Shadyab; Rami Nassir; Jinnie J Rhee; Arti Hurria; Rowan T Chlebowski Journal: J Natl Cancer Inst Date: 2020-02-01 Impact factor: 13.506
Authors: Tomi Akinyemiju; Lauren E Wilson; April Deveaux; Stella Aslibekyan; Mary Cushman; Susan Gilchrist; Monika Safford; Suzanne Judd; Virginia Howard Journal: Cancers (Basel) Date: 2020-06-26 Impact factor: 6.639
Authors: Tomi Akinyemiju; Justin X Moore; Maria Pisu; Michael Goodman; Virginia J Howard; Monika Safford; Susan C Gilchrist; Mary Cushman; LeAnn Long; Suzanne E Judd Journal: Oncotarget Date: 2019-08-06